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Prevalence of Hyperemesis Gravidarum and Associated Factors in Arba Minch General Hospital, Gamo Gofa Zone, Southern Ethiopia

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Prevalence of Hyperemesis Gravidarum and Associated Factors in Arba Minch General Hospital, Gamo Gofa Zone, Southern Ethiopia her and ot C M h il n d i H s e c i a l n t i Kejela et al., Clinics Mother Child Health 2018, 15:1 l h C Clinics in Mother and Child Health DOI: 10.4172/2090-7214.1000285 ISSN: 2090-7214 Research Article Open Access Prevalence of Hyperemesis Gravidarum and Associated Factors in Arba Minch General Hospital, Gamo Gofa Zone, Southern Ethiopia Gemechu Kejela1*, Shimelis Getu2, Tadla Gebretsdik2 and Tesfaye Wendimagegn2 1Department of Public Health, College of Medicine and Health Sciences, Arba Minch University, Arba Minch, Ethiopia 2School of Medicine, College of Medicine and Health Sciences, Arba Minch University, Arba Minch, Ethiopia *Corresponding author: Kejela G, Department of Public Health, College of Medicine and Health Sciences, Arba Minch University, Arba Minch, Ethiopia, E-mail: [email protected] Received date: January 02, 2018; Accepted date: January 30, 2018; Published date: February 05, 2018 Copyright: ©2018 Kejela G, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Abstract Background: Nausea and vomiting of pregnancy (NVP) are common symptoms experienced during pregnancy. Both mild and severe symptoms can have significant morbidities and socioeconomic impact. Despite its frequency and associated distress, its exact cause is unknown. No significant study was done addressing this particular important issue in our country and our globe as well and this study will serve as a bench mark for future work on the topic. Objective: To assess prevalence of hyperemesis gravidarum and associated factors in women attending antenatal care in Arba Minch general hospital. Methods and materials: A descriptive facility based cross-sectional study was done in Arbaminch general hospital. Semi-structured questionnaires were administered to a sample of 183 admitted pregnant women. Descriptive statistic was used to summarize data. SPSS 20 is used to analyse the data. Results: The prevalence of hyperemesis gravidarum was 8.2%. It was found out that 80% had symptoms in the 1st trimester, 2.1% continue to have it after 1st trimester, and 85% were triggered by smell and taste. Conclusions and recommendations: Prevalence and associated factors of hyperemesis gravidarum in this study are similar to other studies. Sensory stimuli were major trigger of symptoms. Keywords: Hyperemesis gravidarum; Arba Minch; General hospital have deleterious effects on the health of the foetus, the baby, and the mother [7]. Introduction According to the Hyperemesis Education and Research Foundation, Nausea and vomiting is a common experience for women in conservative estimates indicate that, HEG can cost a minimum of $200 pregnancy (NVP). Symptoms are usually limited to the first trimester, million annually in in-house hospitalizations in the United States [8]. but can continue throughout pregnancy and even persist until birth In a related economic analysis, Piwko et al. projected that the United [1]. The severity of nausea and vomiting may affect the physical and States spends nearly $2 billion in costs attributed to pregnancy-related emotional health of the pregnant women, family, social and nausea and vomiting; 60% of this expenditure is result of direct costs occupational functioning [2], the stages of maternal role attainment, (e.g., drugs, hospital admission), and 40% is a result of indirect costs and even outcomes for the unborn child like low birth weight [3]. (e.g., time lost from work) [9]. The exact etiologic factor for nausea and vomiting is unknown, but In Germany, in 2005, the yearly cost of hospital admittances alone it is widely agreed that it is a multifactorial condition with genetic, for hyperemesis gravidarum was about 28 million Euros, and the cost physiological, behavioural, dietary, social, and psychological of lost working hours and outpatient treatment is not even included in contributing determinants [4]. However, the reports regarding these this amount [10]. determinants continue to be contradictory and are often restricted to There is increasing evidence that NVP has emerged as a common either the first trimester of pregnancy or hyperemesis gravid arum phenomenon among urbanized human population with increased (HEG), the most severe form of NVP [5]. The overall clinical genetic heterogeneity as its occurrence is rare among foraging symptoms are believed to be highly variable and tend to be affected by population such as the Bushmen of South Western Africa and the the age, marital status, place of residence, race/ethnicity, cultural, Amazonian Amerindian tribes with well documented genetic social, and educational status of the individual [6]. homogeneity [11]. The literatures has shown that worry, stress, anxiety, depression and Apart from the ethnic difference in the occurrence of NVP, some unintended pregnancy as well as cigarette, alcohol and drug use can all anthropometric and demographic factors have also been associated with NVP as studies have reported association between maternal age, Clinics Mother Child Health, an open access journal Volume 15 • Issue 1 • 1000285 ISSN:2090-7214 Citation: Kejela G, Getu S, Gebretsdik T, Wendimagegn T (2018) Prevalence of Hyperemesis Gravidarum and Associated Factors in Arba Minch General Hospital, Gamo Gofa Zone, Southern Ethiopia. Clinics Mother Child Health 15: 285. doi:10.4172/2090-7214.1000285 Page 2 of 5 body weight, parity, sex of foetus, family history and experience in The dependent variable for this study was hyperemesis Gravid previous pregnancy as factors which bears increased risk of developing arum, which is defined as severe (un able to tolerate per mouth severe NVP [12-15]. feeding) form of nausea and vomiting in pregnant mothers characterized by significant weight loss (5% weight loss from pre HEG can be associated with serious maternal and foetal morbidity pregnancy) and ketonuria [10,16]. For data collection, 5 midwifery such as Wernicke’s encephalopathy, foetal growth restriction, and even nurses were recruited as data collectors and 3 MPH professionals were maternal and foetal death [16-19]. In some instances long-lasting, very recruited as supervisors. Data was collected by interviewing admitted intensive vomiting, might in rare cases lead to esophageal mucosal pregnant women using the structured questionnaire after letter of injury/tear (a Mallory-Weiss syndrome), rupture of oesophagus or permission was taken from Arba Minch University ethical review spleen, choroid bleedings, transient hypothyroxinemia, pneumothorax board. as well as neurological complications such as myelinolysis of the cerebellum or Wernicke encephalopathy caused by lack of vitamin B1 To control the quality of data, before data collection, training was [16]. given for data collectors and supervisors. Pre-test was conducted on 5% of the sample and then possible adjustments or modifications were Prim gravidity, null parity, excessive salivation and food aversion made based on the result of pre-test. In addition close supervision was were significantly associated with nausea and vomiting during conducted by supervisors. pregnancy [20-24]. Significant associations were also observed between admission for severity and being unmarried, loss to work, To know the association between variables univariate and bivariate affected relationship, more frequent vomiting, and early onset of analysis was done using binary logistic regression. Finally variables symptoms. Severe frequency of vomiting was a major factor associated with P-value of <0.05 will be considered as statistically significant with admission for severity and loss to work [25]. association with the outcome variable. In our country, the study conducted in Addis Ababa showed that, the prevalence of nausea and vomiting during pregnancy was 74.5%, Results with 4.4% being admitted for severe symptoms. It also found out that 91% had symptoms in the 1st trimester, 2.1% after mid pregnancy, and Socio-demographic characteristics 85% were triggered by smell and taste. The age distribution of the study subjects ranged from18–45 years, Despite the presence of a problem and its severity in Ethiopia, there 95 (51.9%) were between the ages of 25–34 years with a mean age of is scarcity of studies that show the magnitude and factors that 28.04 ± 6.14 years. Most were Gamo 105 (57.4%) in ethnicity, living associated with the problem. So, the main aim of this study was to together 169 (92.3%), completed secondary education 121 (66.1%); assess the prevalence of hyperemesis gravidarum and associated employed 89 (48.6%) (Table 1). factors in women attending Arba Minch general hospital. The study helps all women affected by the problem, health professionals, Socio-demographic variable Frequency Percentage researchers, government bodies and NGOs to solve the problem. In Age in year addition, it provides base line information for further studies to be carried out and also will add a bit to the literature pool of the library ≤ 18 9 4.9 [26-28]. 19-24 50 27.3 Methods 25-34 95 51.9 Institution based cross sectional study was conducted in Arba ≥ 35 29 15.8 Minch general hospital from January 21-January 30, 2016. The hospital Place of residence is found in Arba Minch town, the capital city of Gamo Gofa zone. Arbaminch is located at 505 km from Addis Ababa, the capital city of Rural 62 33.9 the country. The town has 1 zonal hospital and 2 governmental health centres and 69 private
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